Outcome of arthroscopic reduction association of the scapholunate joint

Koehler, Steven M.; Guerra, S.; Kim, J. M.; Sakamoto, Sotetsu; Lovy, Andrew J.; Hausman, Michael R.

doi:10.1177/1753193415577335

Cited by 16 publications

(26 citation statements)

References 28 publications

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“…In regard to the SL ligament injuries, the outcomes of reduction and association of the scaphoid and lunate (RASL) are not consistent, but many of them were still reported to be good. 9 Therefore, we believe that for the intercarpal ligament injuries in this case of 3 weeks after injury, compression the association between the carpal bones for a period of time will still work, although the results could be variable.…”

Section: Discussionmentioning

confidence: 79%

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

2019

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Background Reverse perilunate injuries are rare. Contrary to perilunate injuries, the violent force would start from the lunotriquetral ligament, go reversely toward the radial side, and cause the reverse or ulnar-sided perilunate dislocation. Case Description We describe a 31-year-old man with a reverse perilunate dislocation, who presented to our institution 3 weeks after a motorcycle accident. The patient was successfully treated with the reduction and association of the lunate and triquetrum (RALT) procedure by using closed maneuver and percutaneous headless compression screw fixation. The patient can obtain a good radiographic result and satisfactory function at the 30-month follow-up. Literature Review Many case series were reported concerning the perilunate injuries. However, few cases of reverse perilunate dislocation have been reported in the literature. No cases of reverse perilunate dislocation treated 3 weeks after the injury with the RALT procedure have been reported. Clinical Relevance In this case, we found that the dislocation could still be reduced with the closed maneuver. With the RALT procedure, the carpal alignment can be maintained and the stability can be regained. Also, the functional outcomes are good.

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Section: Discussionmentioning

confidence: 79%

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

2019

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“…35 Data were collected on 805 procedures from a total of 35 papers 25,[28][29][30][31][32] (Table 3). The review included 43 patients from 4 studies involving intentional fibrous nonunion type procedures, 32,41,48,61 391 patients from 14 groups involving capsulodesis, [29][30][31]39,43,47,51,52,54,55,59,60,62,63 319 patients from 12 groups involving tenodesis techniques 25,30,34,36,37,40,[44][45][46]50,53,58 and 51 patients from 4 groups using bone-tissue-bone techniques. 35,42,57,64 Overall, 68% of patients were male, and the patients' average age was 39 years (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Surgical outcomes of chronic isolated scapholunate interosseous ligament injuries: a systematic review of 805 wrists

Montgomery

Rollick

Kubik

et al. 2019

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Background: Management of chronic isolated scapholunate interosseous ligament (SLIL) injuries has generated a substantial volume of low-quality literature with descriptions of multiple new surgical techniques, and the impact of instability pattern and the optimal surgical technique remain unclear. The primary goal of this review was to compare clinical, radiographic and patient-rated outcomes between current surgical techniques. Methods: We performed a systematic literature search using multiple databases. We analyzed clinical, radiographic and patient-reported outcomes. We used a fixedeffects model weighted by sample size with combined outcomes estimated via least squares means with 95% confidence intervals. We also performed a subgroup analysis of static versus dynamic instability. Results: We assessed 805 procedures from 37 study groups, with 429 procedures used in subgroup analysis. There were no statistically significant differences in outcomes between surgical techniques or in subgroup analysis. Overall, postoperative wrist flexion and pain scores decreased, and grip strength and patient-rated outcomes improved. Conclusion: Compared to overall preoperative values, modest improvements in pain score, grip strength and functional outcome scores were obtained from a range of reconstructive procedures performed for chronic isolated SLIL injuries. No significant differences could be ascertained between surgical techniques, potentially owing to the low quality of evidence and procedure heterogeneity. This study provides accurate preoperative reference values for future studies, highlights the controversial clinical impact of instability classification, and the need for higher-quality multicentre or collaborative trials to improve our understanding and management of this common injury. Contexte : La prise en charge des blessures chroniques du ligament interosseux scapho-lunaire (LISL) a généré un volume substantiel d'articles de faible qualité où sont décrites plusieurs nouvelles techniques chirurgicales, mais l'impact du modèle d'instabilité et la technique chirurgicale optimale restent à clarifier. Le principal objectif de cette revue était de comparer les résultats cliniques, radiographiques et autodéclarés par les patients entre les diverses techniques chirurgicales actuelles. Méthodes : Nous avons procédé à une interrogation systématique de la littérature dans plusieurs bases de données. Nous avons analysé les résultats cliniques, radiographiques et autodéclarés par les patients. Nous avons utilisé un modèle à effets fixes pondéré par la taille de l'échantillon, avec paramètres mixtes estimés par les moyennes des moindres carrés et des intervalles de confiance à 95 %. Nous avons aussi effectué une analyse de sous-groupes (instabilité radiographique dynamique c. statique). Résultats : Nous avons évalué 805 interventions dans 37 groupes étudiés, et 429 interventions ont été utilisées dans les analyses de sous-groupes. On n'a noté aucune différence statistiquement significative pour ce qui est des résultats entre...

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“…This is similar to other small series in the literature. [11][12][13][14] We speculate that preservation of motion across an implant will invariably lead to osteolysis and loosening. A loose implant is a known cause of pain.…”

Section: Discussionmentioning

confidence: 98%

“…More recently, Koehler et al reported on 18 patients who underwent the arthroscopically assisted RASL at a mean follow-up of 36 months. 14 The authors noted that patients with a preoperative SL interval greater than 5 mm and arthritic changes between the scaphoid and radial styloid were at a greater risk of complications or failure. In our small series, three patients had a preoperative SL interval greater than 5 mm, two of which went on to have SL interval widening with symptomatic screw osteolysis requiring hardware removal.…”

Section: Discussionmentioning

confidence: 99%

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Reduction and Association of the Scaphoid and Lunate: A Functional and Radiographical Outcome Study

2018

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Background Management of scapholunate (SL) ligament disruption is a challenging problem. The reduction and association of the scaphoid and lunate (RASL) procedure has been described with varying results. This study assessed the outcomes of the RASL procedure. Purpose The objective of this study was to assess the outcomes of patients undergoing the RASL procedure at our institution in regard to pain relief, range of motion, radiographic and functional outcomes, complications, and reoperations. Materials and Methods Twelve patients with symptomatic chronic SL instability underwent the RASL procedure. The mean age was 35 years. The mean time from injury to surgery was 40 weeks. The mean follow-up was 89 months. Outcomes included visual analog score for pain, wrist range of motion, grip strength, and Mayo Wrist Scores. Preoperative and postoperative radiographs were reviewed. Results Pain scores improved in 10 wrists. Range of motion and grip strength worsened. The average Mayo Wrist Score was 63.3. The mean SL diastasis and angle improved, but seven wrists developed progressive degenerative changes, with two requiring a salvage procedure. Symptomatic progressive screw lucency occurred in eight wrists requiring screw removal. Conclusion The RASL procedure can improve SL widening but has a high rate of early failure and reoperation. Following reoperation, long-term follow-up demonstrates reasonable long-term durability in some cases. Level of Evidence This is a Level IV, therapeutic case study.

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Outcome of arthroscopic reduction association of the scapholunate joint

Cited by 16 publications

References 28 publications

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

Reduction and Association of the Lunotriquetral Ligament for Reverse Perilunate Dislocation

Surgical outcomes of chronic isolated scapholunate interosseous ligament injuries: a systematic review of 805 wrists

Reduction and Association of the Scaphoid and Lunate: A Functional and Radiographical Outcome Study

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